<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<title>Untitled Document</title>
</head>

<body>
{$form_open}
<table width="236" border="1">
  <tr>
    <td width="75">Name</td>
    <td width="145"><label for="textfield"></label>
    <input type="text" name="name" id="textfield" /></td>
  </tr>
  <tr>
    <td>Room No.</td>
    <td><input type="text" name="room_no" id="textfield2" /></td>
  </tr>
  <tr>
    <td>&nbsp;</td>
    <td><input type="submit" name="button" id="button" value="Submit" /></td>
  </tr>
</table>
{$form_close}
</body>
</html>
